Frequently Asked Questions

Tumors can be benign (non-invasive and will not spread) or malignant (invasive with the potentialto spread).

Cancer is the leading cause of death in geriatric dogs and cats.

Currently there are less than 75 radiation facilities registered with the Veterinary Cancer Society in the United States. Six are in Florida (which is a lot), two are in Georgia and one in Auburn.

Currently there are 328 board certified veterinary oncologists registered through the American College of Veterinary Medicine, our parent college

As of May 8, 2013, the ACVR membership includes 482 active Diplomates. Thereare 400 Diplomates in Radiology, 65 Diplomates in Radiation Oncology, 17 Diplomates holding dual certification, and 210 Society Only members. The College has 5 Emeritus, 17 Retired, and 1 Associate Member. This is from the American Collegeof Veterinary Radiology which is my parent college for radiation oncology.

Any veterinarian actively participating in a residency training program leading to the radiology or radiation oncology board certification examination is a Resident Member-in-Training. There are 100 Resident Members-in-Training; 87 Residents in Radiology and 13 in Radiation Oncology.

Most pets do NOT go bald from cancer as they do not have a rapidly growing hair coat. If your pet does need haircuts on a regular basis, you can expect chemotherapy related hair loss.

Studies show that more than 70 percent of pet owners think of their pets as children. Cancer is a great health concern among pet owners, and 40 percent worry about their pets having cancer regardless of the age of their pets.

Cancer is the number one cause of death in geriatric patients, BUT cancer is also the most curable of chronic diseases! Success rates vary from pet to pet. Your oncologist will determine your pet’s possible success rate to the best of his/her abilities based on the type of cancer, treatment, and pet’s response. Your oncologist cannot predict the future, but your oncologist can help to keep the quality of your pet’s life as the utmost priority.

The use of a drug or chemical to treat any illness is chemotherapy, but this term commonly refers to the use of drugs in the treatment of cancer. The goal of chemotherapy in companion animals is either to increase the life span or to improve the quality of life for the animal with cancer.

HowDoes Chemotherapy Work?

Cancer can be defined as a rapid, uncontrolled growth of cells. Anticancer chemotherapy drugs work by blocking cell growth and division. Different drugs interfere with different steps in these processes. In many cases, a combination of drugs is the most effective way to kill the cancer cells.

How is Chemotherapy Given?

Most anticancer drugs are given by mouth (pill form) or by injection. The route chosen depends on the type of drug and the type of cancer.

How Long Will my Pet Receive Chemotherapy?

The length of time and frequency of drug administration depend on the kind of cancer being treated and how well the therapy is tolerated by the patient. Treatment may be given daily, weekly, or monthly.

Am I at Risk of Exposure to These Drugs?

Yes. Most anticancer drugs are very potent and must be handled with care. Some are carcinogens and can cause cancer with prolonged exposure. With orally administered drugs, it is important that the pills or capsules are kept out of reach of children in childproof containers. When handling these drugs, the owner should wear latex or polyvinyl gloves to avoid unnecessary exposure. With oral and injectable drugs, the urine and feces of the animal may be contaminated with active drug compounds for several days after administration. Always avoid contact with the urine and feces of animals receiving chemotherapy. Wear latex or polyvinyl gloves to clean up accidents or the litter box.

Rinse hands after handling any chemotherapy tablets and when cleaning up any excrement for the immediate time after chemotherapy administration. If you have any questions regarding your pet’s specific treatment, please do not hesitate to call us.

What Side Effects Does Chemotherapy Cause?

Veterinarians try to choose drug doses and combinations that cause the fewest side effects. Ideally, the animal receiving chemotherapy does not even realize that he or she is ill or receiving treatments. The drugs used in chemotherapy, however, are extremely potent and side effects can occur. The potential for side effects must be balanced against the benefits of the chemotherapy and the side effects of the cancer if left untreated. Choosing chemotherapy for your pet is an individual decision. Happily 85% of pets never experience side effects from chemotherapy.

What Kind of Side Effects Occur?

Side effects arise because the normal cells in the body are also exposed to the anticancer drug. The most sensitive normal cells are found in the blood, gastrointestinal tract, skin, and reproductive system. Consequently, potential side effects include infection, bleeding, decreased appetite, vomiting, diarrhea, thin haircoat or skin color changes, and sterility. Rare side effects associated with specific drugs include bladder discomfort, kidney damage, and heart failure. The most seriousside effect is overwhelming infection that can be life-threatening.

What Are The Most Common Side Effects?
The most common side effect reported by owners is that the pet seems to be “off” for a day or two. This might mean that the pet has slightly less energy or seems less excited than normal about eating. Less commonly, the pet may skip a meal or two, have one episode of vomiting or diarrhea, or seem lethargic. Unfortunately, there is no way to predict which pet will develop the most serious reactions. The animal receiving chemotherapy needs to be watched closely and taken to his or her veterinarian at the first sign of illness.

Most dogs and cats won’t lose significant amounts of hair. However, breeds that require periodic hair trimming, such as poodles, spaniels, and some terriers, can lose significant amounts of hair. After chemotherapy, it’s common for hair to regrow in a different texture or color. Breeds with “feathers” (varying layers of fur) will lose longer hairs, and some fur that’s been shaved for catheter placement or surgery may not regrow as quickly. Cats also may lose whiskers. However, most hair usually regrows after chemotherapy treatment.

Most chemotherapy is administered on an outpatient basis. This means your pet will spend a few to several hours during the day at our hospital but won’t need to stay overnight. The type of drugs used and administration method will determine the length of each visit.

Radiation therapy is a method of treating cancer with x-rays or electrons. The effectiveness of radiation therapy varies depending on tumor size, patient species, cancer type, and tumor location. It is most effective at treating tumors that occur in one area (localized disease) rather than tumors that have spread to other parts of the body (systemic disease). There are various different types of radiation therapy. Stereotactic radiosurgery (SRS) consists of 1-3 treatment sessions delivered on consecutive days, while conventional radiation therapy is typically given every day for a period of three to four weeks. Each treatment requires a brief general anesthesia. Both normal and cancer cells are affected, but radiation treatment is designed to maximize tumor effect and minimize the effect on normal tissues. While normal cells can regenerate following radiation exposure, cancer cells cannot.

Radiation therapy can be used to provide pain relief and occasionally to attempt rapid tumor shrinkage to provide immediate relief from pressure, bleeding, or pain. This is called palliative treatment. The most useful situation for palliative radiation is to relieve pain from bone tumors.

Tumor stage refers to ‘how far the cancer has spread’ within a patient. It is important for your oncologist to determine tumor stage in order to have the best medical information possible to provide optimal treatment recommendations for your pet. Each pet is an individual! Some examples of testing that might be performed for ‘tumor staging’ include:

Chest radiographs (x-rays) to see if the tumor has spread to the lungs and to aid in assessment of the heart.

Abdominal ultrasound to see if the tumor has spread to any of the abdominal organs.

Cytology to see if cancer cells are present within a sample of cells from any particular organ. This sample is obtained by a fine needle aspirate .

Biopsy to see what type of cancer your pet has, and often to aid in obtaining tumor grade.

CT scan (three dimensional x-ray imaging) in order to really see how far the tumor spreads locally, and to identify if any critical organs or bones are invaded by the tumor. CT is also frequently performed to aid in radiation treatment planning.

Tumor grade is information obtained from the biopsy of your pet’s tumor. Your oncologist will look for tumor grade on a pathology report if it will aid in prognosis or treatment recommendations for patients. It often will! Tumor grade is often categorized as low grade, intermediate grade, or high grade.

If your pet’s oncologist is considering or recommending cryotherapy, the following information will be useful in helping you understand what cryotherapy is and what to expect after treatment. As always, we are more than happy to answer any additional questions you might have reguarding cryotherapy or any other procedure.

What is Cryotherapy?
Cryotherapy is the controlled use of cold temperature to induce cellular destruction. Nitrous oxide or liquid nitrogen is used to achieve an extremely cold temperature. One of these substances is sprayed into a funnel shaped device that protects the surrounding skin. By using this method, we are able to treat the tumor and spare surrounding normal tissues. Anesthesia may not be required! The end result is an effective, precise, less invasive procedure for your pet.

Is The Procedure Painful?
Humans who have cryotherapy report a slight burning sensation that lasts three-to-five seconds. Some patients feel nothing at all. One benefit of cryotherapy is that as soon as an area is treated, the freezing process acts as its own anesthetic to the site. This means that after the initial sensation the patient no longer feels any discomfort. If multiple treatments are necessary for the same area or your pet seems to feel discomfort, your oncologist may use local anesthetics (numbing agents) to desensitize the area.

Will my Pet Need Sedation or Anesthesia During Its Treatment?
Your pet may need light sedation for this procedure depending on the location and size of the area being treated. Sedation or anesthesia may be necessary because it is vital your pet remains still while the procedure is being done to ensure safety and success. If your pet will be receiving sedation or anesthesia for any other procedure, the cryotherapy will be done during this time. Remember, the freezing process acts as its own anesthetic.

What Should I Expect After my Pets Treatment?
Within a few hours to a few days the treated area may form a blister, turn black, or begin to scab. This is expected. Keep the treated area as dry as possible. Bandages are not recommended or necessary post treatment. Do NOT allow your pet to lick or scratch at the area. Licking and scratching can slow down or complicate the body’s natural healing process. Sometimes large blisters can develop in the treated area. If this occurs, they can be drained and treated. Do NOT treat them yourself. Scabs, if they occur, will eventually fall off on their own. Do not pick or pull at the area. Once the scab has fallen off the treated area may be somewhat red. It may also be slightly more sensitive to temperature, touch, and can feel itchy as it heals.

A malignant tumor is a tumor which has the ability to metastasize, or spread to other sites in the body. A benign tumor does not have this capability. Malignant tumors and benign tumors are both tumors, nonetheless. Tumors are a population of cells with uncontrolled growth. A benign tumor, therefore, does have the ability to take a patient’s life if located in a critical location (for example, the brain or nasal cavity).

Your pet has received a dose of chemotherapy called vincristine or vinblastine today. Vincristine is also known as oncovin. Please keep the following information handy in case of any questions:

Possible side effects include:

Vomiting, Diarrhea, Lack of Appetite: This usually begins two or three days after the drug is administered. If your pet refuses all food and water for 24 hours, vomits more than three times in one day, or has profuse or bloody diarrhea, please contact us or the nearest emergency clinic immediately.

Irritation at The Injection Site: More likely with vincristine than vinblastine. This drug is irritating if administered outside of a vein, or if it accidentally leaks outside of a vein. Every precaution is taken to prevent “extravasation” from occurring; however sometimes it happens despite these best efforts. Please contact us if your pet is excessively licking or scratching at the administration site. Notify us if any break in the skin or swelling is noted.

Constipation or Abdominal Discomfort: These side effects are more commonly reported in people receiving vincristine; however, it can occur in pets. Notify us should your pet be having either of these symptoms.

Bone Marrow Suppression: As with all chemotherapy drugs, suppression of the immune system with subsequent increased susceptibility to infection is possible. This usually occurs between seven and ten days post drug administration but can be variable. This is the reason we evaluate blood tests from your pet before each and every dose of chemotherapy! Please let us know if your pet is feeling poorly at any time during chemotherapy. We may ask you to take your pet’s temperature at home or we may prescribe oral antibiotics to prevent/treat infection in your pet.

Hair Loss: Will not usually occur in animals as they do not have a rapidly dividing hair coat. Dogs who need regular grooming/hair trims may lose some or all of their hair, usually after two to three doses of drug have been administered. Cats will usually only lose their whiskers. Hair coat and whiskers will grow back after chemotherapy administration is complete.

Increased thirst, increased urination, excessive panting, and increased appetite!
With chronic use, patients may experience muscle wasting or abnormalities of their endocrine system. Most patients do not have significant problems with steroid usage and benefit enormously from their anti-inflammatory or anti-cancer properties. HOWEVER, some patients are extremely sensitive to the side effects and the dosage must be adjusted to improve quality of life. Please allow your oncologist to adjust the dosage based on your reports of your pet’s quality of life.

Prednisone or prednisolone should NOT be used in combination with non-steroidal anti-inflammatory medications (NSAIDs); several of the common veterinary NSAIDs include rimadyl, deramaxx, piroxicam, metacam, previcox, and even human formulation aspirin (regular or baby strength aspirin). These medications, when used in combination with prednisone or prednisolone, can cause serious GI disturbances, stomach or intestinal ulcers, and liver disease. Please inform your oncologist if you pet is on any NSAID therapy and check with your oncologist before starting your pet on any NSAID therapy!

Constipation or abdominal discomfort: These side effects are more commonly reported in people receiving vincristine; however, it can occur in pets. Notify us should your pet be having either of these symptoms.

Bone marrow suppression: As with all chemotherapy drugs, suppression of the immune system with subsequent increased susceptibility to infection is possible. This usually occurs between seven and ten days post drug administration but can be variable. This is the reason we evaluate blood tests from your pet before each and every dose of chemotherapy! Please let us know if your pet is feeling poorly at any time during chemotherapy. We may ask you to take your pet’s temperature at home or we may prescribe oral antibiotics to prevent/treat infection in your pet.

Hair loss: Will not usually occur in animals as they do not have a rapidly dividing hair coat. Dogs who need regular grooming/hair trims may lose some or all of their hair, usually after two to three doses of drug have been administered. Cats will usually only lose their whiskers. Hair coat and whiskers will grow back after chemotherapy administration is complete.

Your pet has received prescription of piroxicam today. This drug is also known as feldene. Please keep the following information handy in case of any questions:

Possible side effects include:

Vomiting, diarrhea, lack of appetite: This usually is not a problem but can arise with chronic (greater than one week) use of this drug. If your pet refuses all food and water for 24 hours, vomits more than three times in one day, or has profuse diarrhea with blood in it, discontinue the drug and notify us immediately. We may modify the dose or discontinue the drug, but do not do this without speaking to your oncologist first.

Kidney damage: This is a possibility with any non-steroidal anti-inflammatory drug. Please ensure that your pet has plenty of water to drink at all times. Do NOT give this drug simultaneously with any other steroid or any increase in water consumption or urination while receiving this drug.

Your pet has received an intravenous dose OR prescription of chemotherapy called cyclophosphamide today. This drug is also known as cytoxan. Please keep the following information handy in case of any questions:

Possible side effects include:

Vomiting, Diarrhea, Lack of Appetite: This usually begins two or three days after the drug is administered. If your pet refuses all food and water for 24 hours, vomits more than three times in one day, or has profuse or bloody diarrhea, please contact us or the nearest emergency clinic immediately.

Urinary Bladder Irritation: This typically occurs in small breed dogs, but can rarely be noted in large breed dogs. To prevent this side effect, we give a diuretic injection with the intravenous form of this drug, to dilute the urine and decrease the chance of bladder irritation. Signs of bladder irritation mimic a urinary tract infection for example, you may see straining to urinate, blood in the urine, or many more quick attempts at urinating than usual. Please notify us if you see this at any time during your pet’s treatment. Things you can do at home to help prevent such a side effect include: give pills (if prescribed) in the morning versus at night, offer plenty of fresh water, and take your pet outside frequently to prevent holding of urine in the bladder.

Bone Marrow Suppression: As with all chemotherapy drugs, suppression of the immune system with subsequent increased susceptibility to infection is possible. This usually occurs between seven and ten days post drug administration but can be variable. This is the reason we evaluate blood tests from your pet before each and every dose of chemotherapy! Please let us know if your pet is feeling poorly at any time during chemotherapy. We may ask you to take your pet’s temperature at home or we may prescribe oral antibiotics to prevent/treat infection in your pet.

Hair Loss: Will not usually occur in animals as they do not have a rapidly dividing hair coat. Dogs who need regular grooming/hair trims may lose some or all of their hair, usually after two to three doses of drug have been administered. Cats will usually only lose their whiskers. Hair coat and whiskers will grow back after chemotherapy administration is complete.

Your pet has received a dose of chemotherapy called carboplatin (or paraplatin) today. Please keep the following information handy in case of any questions:

Possible side effects include:

Vomiting, Diarrhea, Lack of Appetite: This usually begins two or three days after the drug is administered. If your pet refuses all food and water for 24 hours, vomits more than three times in one day, or has profuse or bloody diarrhea, please contact us or the nearest emergency clinic immediately.

Bone Marrow Suppression: As with all chemotherapy drugs, suppression of the immune system with subsequent increased susceptibility to infection is possible. This usually occurs between ten and fourteen days post drug administration but can be variable. Cats might even experience low white cell counts as late as four weeks post drug administration. Dogs or cats might experience low platelet counts. Platelets are necessary to help blood to clot and white cells are necessary to help fight off infections. Because these cells are very important, we will want to evaluate blood tests from your pet before each and every dose of chemotherapy! Please let us know if your pet is feeling poorly at any time during chemotherapy. We may ask you to take your pet’s temperature at home or we may prescribe oral antibiotics to prevent/treat infection in your pet.

Hair Loss: Will not usually occur in animals as they do not have a rapidly dividing hair coat. Dogs who need regular grooming/hair trims may lose some or all of their hair, usually after two to three doses of drug have been administered. Cats will usually only lose their whiskers. Hair coat and whiskers will grow back after chemotherapy administration is complete.

Your pet has received a dose of chemotherapy called L-asparginase today. Please keep the following information handy in case of any questions:

Possible side effects include:

Vomiting, diarrhea, lack of appetite: This usually begins two or three days after the drug is administered. If your pet refuses all food and water for 24 hours, vomits more than three times in one day, or has profuse or bloody diarrhea, please contact us or the nearest emergency clinic immediately.

Allergic reactions: This usually occurs immediately (within 10-20 minutes) of giving the drug here in the hospital. Rarely, DOGS can have a delayed reaction up to hours later. This reaction would likely appear as facial swelling, hive formation in the skin, and/or difficulty breathing. Please call us or your nearest emergency veterinarian should any of these symptoms occur.

Your pet has received a dose of chemotherapy with either a drug called Adriamycin (also known as doxorubicin) or mitoxantrone today. These drugs are related to each other. Please keep the following information handy in case of any questions:

Possible side effects include:

Vomiting, diarrhea, lack of appetite: This usually begins two or three days after the drug is administered. If your pet refuses all food and water for 24 hours, vomits more than three times in one day, or has profuse or bloody diarrhea, please contact us or the nearest emergency clinic immediately.

Irritation at the injection site: This drug is extremely irritating if administered outside of a vein, or if it accidentally leaks outside of a vein. Every precaution is taken to prevent “extravasation” from occurring; however sometimes it happens despite these best efforts. Please contact us if your pet is excessively licking or scratching at the administration site. Notify us if any break in the skin or swelling is noted.

Bone marrow suppression: As with all chemotherapy drugs, suppression of the immune system with subsequent increased susceptibility to infection is possible. This usually occurs between seven and 10 days post drug administration but can be variable. This is the reason we evaluate blood tests from your pet before each and every dose of chemotherapy! Please let us know if your pet is feeling poorly at any time during chemotherapy. We may ask you to take your pet’s temperature at home or we may prescribe oral antibiotics to prevent/treat infection in your pet.

Heart damage: This is a rare and dose-related side effect of Adriamycin. We carefully screen pets with a cardiac evaluation prior to giving Adriamycin before the first, fourth, fifth, and sixth doses of drug. If you notice your pet experiencing weakness, exercise intolerance, or collapsing episodes, notify us immediately.

Hair loss: Will not usually occur in animals as they do not have a rapidly dividing hair coat. Dogs who need regular grooming/hair trims may lose some or all of their hair, usually after two to three doses of drug have been administered. Cats will usually only lose their whiskers. Hair coat and whiskers will grow back after chemotherapy administration is complete.

American College of Veterinary Radiology (ACVR) was founded in 1961 to determine competence of voluntary candidates in veterinary radiology and to encourage the development of teaching personnel and training facilities in veterinary radiology.

Veterinary Cancer Society was formed in 1976 by an interested group of veterinary oncologists. It is a non-profit educational organization whose current membership numbers around 600 and includes specialists in medical, surgical, and radiation oncology, internists, pathologists, pharmacologists, and general practitioners from all over the United States and the world.

PetCure Oncology is a national veterinary cancer care provider that specializes in radiation oncology and is the leading provider of stereotactic radiosurgery (SRS) for pets. With locations across the country, PetCure is dedicated to providing pets with access to the same advanced cancer care options that are available in human medicine.